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The diagnosis is becoming more common with 1.0% of Australians being diagnosed in 2017–18.

These are not commonly required.Ĭhronic kidney disease is defined by a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m 2 or evidence of glomerular-tubular injury, for example haematuria or proteinuria. Close monitoring of drug effect and toxicity is also needed and can be supported by therapeutic drug monitoring.įor short courses of drugs with a wide therapeutic index, dose adjustment may not be needed.Īlternative methods for quantifying kidney function include the Cockcroft-Gault formula (estimates creatinine clearance) or direct measures of glomerular filtration rate using exogenous isotope compounds. It may need to be adjusted for body surface area, particularly for drugs with a narrow therapeutic range or requiring a minimum concentration to be effective. However, the formula can be misleading in some patient subsets and other approaches are required.Īt extremes of body mass, the estimated glomerular filtration rate can under- or overestimate kidney function. The estimated glomerular filtration rate can generally be used to guide dose adjustment in patients with stable kidney function. This adjustment depends on the severity of the disease and what proportion of the drug is eliminated by the kidneys. Drugs excreted by the kidney require dose reduction in chronic kidney disease.